Biomedical subjects

Khalaf Al-Shammari

Publications and source records attributed to Khalaf Al-Shammari.

9 recordsLinked to original sources

PubMed2006

Effects of a mineralized human cancellous bone allograft in regeneration of mandibular Class II furcation defects.

BACKGROUND: A solvent-preserved, mineralized human cancellous bone allograft (MBA) was recently developed. However, its effect in regenerating furcation defects remains to be determined. Hence, the aim of the study is to evaluate the effects of this newly introduced MBA, with and without a bioabsorbable collagen membrane, for the treatment of mandibular class II furcation defects. METHODS: Thirty subjects with Hamp's Class II buccal or lingual furcation defects in lower molars were randomly assigned to open flap debridement (OFD), MBA, or MBA with a bioabsorbable collagen membrane (guided tissue regeneration [GTR]+MBA) groups. Clinical and defect measurements were obtained at the initial visit and at 6-month reentry surgeries. The data were analyzed for intra- and intergroup comparisons and associations of treatment with probability of clinical improvement. RESULTS: Out of a total of 30 subjects, 27 individuals completed the study. Vertical bone fill (VBF) was -1.6+/-2.1 mm in OFD, 1.9+/-1.4 mm in MBA, and 0.7+/-0.9 mm in GTR+MBA groups. VBF in MBA and GTR + MBA groups was significantly higher than that in the OFD group (P<0.05). Horizontal bone fill (HBF) was 0.2+/-1.7 mm, 1.1+/-0.9 mm, and 1.1+/-0.9 mm for OFD, MBA, and GTR+MBA groups, respectively. However, HBF, recession, clinical attachment level gain, and probing depth reduction at furcations showed no differences among groups. CONCLUSIONS: Results obtained from this study indicate that solvent-preserved, mineralized human cancellous allograft, with or without collagen membrane, can significantly improve bone fill in mandibular Class II furcation defects. In addition, initial vertical defect depth was found to be the only factor that was associated with a higher probability of clinical improvement.

Adult↗

PubMed2006

Factors influencing treatment outcomes in mandibular Class II furcation defects.

BACKGROUND: Factors influencing treatment outcomes in furcation defects remain to be studied. Therefore, the aim of the study was to evaluate the association between factors and clinical parameters that may influence treatment outcomes in mandibular Class II furcation defects. METHODS: Twenty-seven systemically healthy subjects with a Class II buccal or lingual furcation defect in lower molars were treated. Clinical measurements (probing depth [PD], clinical attachment level [CAL], recession, mobility, plaque index [PI], and bleeding on probing [BOP]) and defect (vertical and horizontal defect depths) were obtained at initial and 6-month reentry surgeries. Treatment modalities (e.g., nine each in the following three groups: open flap debridement [OFD] alone, bone graft [BG], and bone graft plus a bioabsorbable collagen membrane [BG + C]), anatomic factors (presence of cervical enamel projection, presence of cervical restorations/fixed prosthesis, and location of furcations [buccal or lingual sides; first or second molars]), clinical parameters (initial mobility, initial PD at furcation, initial CAL at furcation, mean initial PD of the tooth, mean initial CAL of the tooth, initial horizontal PD at furcation, initial horizontal/vertical defect depth, PI, and BOP), and background factors (endodontic status, smoking status, and surgeon's experience) were analyzed for associations with probability of clinical improvement. RESULTS: The anatomic factors, clinical parameters, and background information were found to have no effect in influencing treatment outcome with the exception of initial vertical defect depth. An initial vertical defect depth >or=4 mm had a borderline significance (P = 0.06) of achieving a high probability of having a 1-mm vertical bone fill. In addition, treatment modality was found to be a major influence factor. Sites treated with BG were 16x more likely to have >50% vertical bone fill than open flap surgery. Furthermore, sites treated with BG were 64x more likely to have a 1-mm vertical defect fill compared to sites treated with OFD and 16x more likely to have a 2-mm vertical defect fill compared to sites treated with OFD or BG + C. However, the additional membrane does not enhance the regenerative outcomes achieved by BG alone. CONCLUSIONS: Initial vertical defect depth (>or=4 mm) and treatment modality (e.g., BG) were found to be the clinical parameter and factor that were associated with high probability of clinical improvement. Sites treated with BG, such as mineralized human cancellous allograft, were more likely to have greater vertical furcation defect fill than the conventional OFD surgery. Additional membrane placement does not enhance the treatment outcome achieved by BG alone.

Adult↗

PubMed2005

Clinical response of azithromycin as an adjunct to non-surgical periodontal therapy in smokers.

BACKGROUND: Antibiotic therapy can be used in very specific periodontal treatment situations such as in refractory cases of periodontal disease found to be more prevalent in smokers. This study was designed to determine the efficacy of azithromycin (AZM) when combined with scaling and root planing (SRP) for the treatment of moderate to severe chronic periodontitis in smokers. METHODS: Thirty-one subjects were enrolled into a 6-month randomized, single-masked trial to evaluate clinical, microbial (using benzoyl- DL-arginine naphthylamine [BANA] assay), and gingival crevicular fluid (GCF) pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP) levels in response to SRP alone or SRP + AZM. At baseline, patients who smoked > or =1 pack per day of cigarettes who presented with at least five sites with probing depths (PD) of > or =5 mm with bleeding on probing (BOP) were randomized into the test or control groups. At baseline and 3 and 6 months, clinical measurements (probing depth [PD], clinical attachment loss [CAL], and bleeding on probing [BOP]) were performed. GCF bone marker assessment (Ctelopeptide [ICTP] as well as BANA test analyses) were performed at baseline, 14 days, and 3 and 6 months. RESULTS: The results demonstrated that both groups displayed clinical improvements in PD and CAL that were sustained for 6 months. Using a subject-based analysis, patients treated with SRP + AZM showed enhanced reductions in PD and gains in CAL at moderate (4 to 6 mm) and deep sites (>6 mm) (P <0.05). Furthermore, SRP + AZM resulted in greater reductions in BANA levels compared to SRP alone (P <0.05) while rebounds in BANA levels were noted in control group at the 6-month evaluation. No statistically significant differences between groups on mean BOP and ICTP levels during the course of the study were noted. CONCLUSIONS: The utilization of AZM in combination with SRP improves the efficacy of non-surgical periodontal therapy in reducing probing depth and improving attachment levels in smokers with moderate to advanced attachment loss.

Adult↗

PubMed2005

Effects of vitamin-B complex supplementation on periodontal wound healing.

BACKGROUND: Reports have demonstrated that nutrient supplements, in particular vitamin-B complex (Vit-B), can positively influence wound healing processes. However, limited information is available on the effects of Vit-B on periodontal wound healing. METHODS: A total of 30 patients (13 males, 17 females) presenting with generalized moderate to severe chronic periodontitis were enrolled in this study. All subjects presented > or = two teeth in the same sextant with probing depth (PD) > or =5 mm and bleeding upon probing (BOP) in need of access flap surgery (AFS). This study was a randomized, double-masked, placebo-controlled clinical trial. Subjects were instructed to take one capsule a day of either Vit-B (50 mg of the following: thiamine HCl, riboflavin, niacinamide, d-calcium pantothenate, and pyridoxine HCl; 50 microg each of d-biotin and cyanocobalamin; and 400 mcg of folate) or placebo for 30 days following AFS. Clinical attachment levels (CAL) and N-benzoyl-dl-arginine-2-naphthylamide (BANA) test scores were measured at baseline and at 90 and 180 days following surgical intervention. Assessments of the healing response were also performed using BOP, gingival index (GI), and plaque index (Pl) at baseline and 7, 14, 30, 90, and 180 days. The mean results of each parameter were averaged within a group. Differences between groups were analyzed by using repeated measures analysis of variance (ANOVA). RESULTS: Both groups experienced comparable levels of PD reduction following AFS (test: -1.57 +/- 0.34; control: -1.50 +/- 0.21). Changes in mean CAL were more favorable in Vit-B supplemented subjects (test: +0.41 +/- 0.12; control: -0.52 +/- 0.23; P = 0.024). Stratified data demonstrated significantly better results for the test group in both shallow (test: -0.08 +/- 0.03; control: -1.11 +/- 0.27; P = 0.032) and deep sites (test: +1.69 +/- 0.31; control: +0.74 +/- 0.23; P = 0.037). No significant differences were observed between groups regarding PI, GI, and BOP. BANA test values were significantly reduced in both groups after surgical treatment and no significant differences were noted between groups. CONCLUSION: Vitamin B-complex supplement in combination with AFS resulted in statistically significant superior CAL gains when compared to placebo.

Adult↗

PubMed2004

Implant plastic surgery: a review and rationale.

Implant dentistry has been established as a predictable treatment modality with high clinical success rates. Esthetic considerations of implant restorations have been gaining increased interest over the years. The role of periodontal plastic surgical procedures in the creation and maintenance of peri-implant soft tissue heights to facilitate better esthetics has become more popular. The available plastic surgery procedures and their clinical applications are reviewed in this article. Emphasis is placed on factors to consider for proper case selection and ideal treatment planning.

Alveoloplasty↗

PubMed2004

Effects of implant thread geometry on percentage of osseointegration and resistance to reverse torque in the tibia of rabbits.

BACKGROUND: Dental implant thread geometry has been proposed as a potential factor affecting implant stability and the percentage of osseointegration. Therefore, the aim of this prospective, randomized, parallel arm study was to evaluate the effects of dental implant thread design on the quality and percent of osseointegration and resistance to reverse torque in the tibia of rabbits. METHODS: Seventy-two custom-made, screw-shaped, commercially pure titanium implants (3.25 mm diameter x 7 mm length) were placed in the tibiae of 12 white New Zealand rabbits. Each tibia received three implants of varying thread shapes: one with a V-shaped, one with a reverse buttress, and one with a square thread design. The rabbits were sacrificed following an uneventful healing period of 12 weeks. Implants in the right tibiae underwent histologic and histomorphometric assessments of the bone-to-implant contact (BIC) and the radiographic density of surrounding bone, while implants in the left tibiae were used for reverse-torque testing. Differences between the three thread designs were examined using analysis of variance (ANOVA). RESULTS: Data showed that the square thread design implants had significantly more BIC and greater reverse-torque measurements compared to the V-shaped and reverse buttress thread designs, while no differences were found in radiographic bone density assessments. CONCLUSION: These results indicate that the square thread design may be more effective for use in endosseous dental implant systems.

Analysis of Variance↗

PubMed2003

Influence of sex hormones on the periodontium.

OBJECTIVES: Sex hormones have long been considered to play an influential role on periodontal tissues, bone turnover rate, wound healing and periodontal disease progression. The objectives of this review article are to (1) address the link between sex hormones and the periodontium, (2) analyse how these hormones influence the periodontium at different life times and (3) discuss the effects of hormone supplements/replacement on the periodontium. MATERIALS AND METHODS: Two autonomous searches were performed in English language utilizing Medline, Premedline and Pubmed as the online databases. Publications up to 2002 were selected and further reviewed. In addition, a manual search was also performed including specific related journals and books. RESULTS: It is certain that sexual hormones play a key role in periodontal disease progression and wound healing. More specifically, these effects seem to differentiate by gender as well as lifetime period. In addition, the influence of sex hormones can be minimized with good plaque control and with hormone replacement. CONCLUSION: Despite profound research linking periodontal condition with sex hormones kinetics, more definitive molecular mechanisms and therapy still remain to be determined.

Alveolar Bone Loss↗

PubMed2003

Stereolithographic surgical templates for placement of dental implants in complex cases.

In recent years, dental implant rehabilitation has faced demands from prosthetic and esthetic arenas that call for increasingly ideal outcomes, which require precise surgical planning and placement. Anatomic limitations and bone quantity and quality can now be evaluated using more sophisticated radiographic techniques, although transferring this information to the surgical phase has been at best a difficult task. Recently, computer-aided design and manufacturing have made it possible to use data from computerized tomography to not only plan implant rehabilitation, but also to transfer this information to the surgery. One of these techniques uses stereolithography, a laser-driven polymerization process that fabricates an anatomic model and surgical templates. This novel approach is illustrated with two advanced cases, demonstrating that the technique not only allows for the precise translation of the treatment plan directly to the surgical field, but also offers many significant benefits over traditional procedures.

Bone Transplantation↗

PubMed2002

HVC ridge deficiency classification: a therapeutically oriented classification.

Alveolar ridge defects resulting from tooth extraction, trauma, or periodontal disease often require surgical correction prior to prosthodontic reconstruction. Whether implants or conventional fixed prostheses are planned, without careful consideration and proper treatment planning, hard and/or soft tissue defects may lead to functional, structural, or esthetic compromises in the final prosthesis. This article reviews the etiology and treatment of alveolar ridge defects and introduces a therapeutically oriented classification system of such defects (horizontal, vertical, and combination-HVC-classification). In addition, a decision-making guide for approaching each defect type will be discussed, and clinical examples of treated cases will be presented.

Alveolar Bone Loss↗